What keeps erections healthy? That’s right, circulation, the
right balance of hormones, and pleasure. But we have many common misperceptions
about how each of these things might help or hurt erections.

Foundationally erections are about blood flow and blood
containment. As the spongy tissues in the penis fill with blood, they swell and
create the hardness of an erection. Blood has to be able to get into the penis
and to be held in there for the erection to last.

Because of the concept of capturing blood in the penis to
hold erection, many men unconsciously tense their pelvic muscles, willing blood
into the penis and willing it to stay there. This does not work. The muscles in
your body do not send blood flow into the penis. In fact, flexible, relaxed
muscles in the pelvis will facilitate more blood flow to the penis. You want
the muscles in your hips, thighs, and pelvis to stay relaxed while you are
getting erect. Practicing stretches for the hamstrings, buttocks, and psoas
muscles can be helpful to keep yourself flexible. (You may find this helps your
sexual functioning in many ways!) Try to become aware of your PC muscle, the
muscle you can use to stop the flow of urine or to cause your penis to twitch.
Learn to feel your PC and relax it, along with surrounding muscles, while
getting erect. Your PC muscle should stay relaxed until the final stages of
orgasm when it can potentially increase sensation and ejaculation. When you
feel you are going over the edge into orgasm, then tighten your PC and see how
that feels.

For men who are struggling with inconsistent erections,
there are some other simple things you can consider and experiment with to
improve circulation. One common factor - Digestion requires circulation to go
to your stomach. Eat lightly before you plan to have sex; you can binge on
whatever your stomach desires after. Also consider using sexual positions that
facilitate circulation such as you standing or kneeling. Missionary position,
when your weight is in your arms, can compromise circulation to your pelvis, so
you might avoid it. And, if your partner is on top, make sure they are not
putting all their weight onto your pelvis.

Ok, what about hormones? For many people this is the first thing
they consider if erectile difficulties come into play. Hormone levels vary considerably
person to person and throughout our lives. Getting testosterone checked can be
helpful but often is not the answer. Focusing on general health, eating well,
sleeping enough, lowering stress, exercising, may all have positive effects on hormone
health. But we are still learning about how to access and supplement for the
right balance of sex hormones for each unique person.

Which brings us to pleasure, an often ignored part of the equation.
Yes, your body is wired to be inspired by pleasure which feeds the erection
process. In the past you may have gotten an erection with just visual
stimulation (pleasurable!), but now you may need the more direct physical
pleasure of manual stimulation to get erect. Relax and enjoy this part of the
sexual process. Allow yourself to focus on what you are feeling, breathe
deeply, and tune in to your own pleasure. When sex becomes stressful, because
it has turned into a performance or a race to please your partner or an
obligation to get over with before you can fall asleep, the body responds. If
you lose track of your own sensation of pleasure, your body assumes you don’t need
an erection anymore. Having positive interactions with your partner and enjoying
a sexual repertoire that doesn’t always rely on an erection for you to have
pleasure together is key because it reduces stress and keeps sexual play fun. You
can have and give intense pleasure without an erection. You can orgasm and
ejaculate without an erection. Your pleasure is important. Explore new ways to
feel it without pressure.

So for my friends with penises out there and those who love
them, here’s to you! Relax, enjoy and happy pleasuring.

There are many ways we learn to protect ourselves, many
forms of armor and resistance, some that serve us well and some not so well.
Overtime we develop patterns of shutting out interactions that we wish to
avoid, based on our own unique history and wounds. Some tense up in the face of
aggressive authority and some numb out when fearing abandonment. Some go into
denial when faced with a painful truth. These forms of resistance make sense;
they are clearly designed to protect us, even as they often cause their own pain.

But what has been fascinating to witness as a therapist is that
we also protect ourselves from things we really deeply want. I don’t mean the
way you want a chocolate bar or a nap. I
mean the things you have yearned for and feared you might never have, the things
that make you feel on the outside looking in, the things that years ago you might have
decided you didn’t deserve. There are things we so deeply want that we create
armor around ourselves to resist letting them in. Why? Because they scare us. A
lot.

I believe that most of the things that people feel afraid to
want are really very simple things, but at one point in our life they were
denied to us when we really needed them. Once denied, it becomes too risky to
trust that we may ever be given this gift. And so we stay wanting, unable to recognize
that we can have it right now. Here it is.

So you may have been emotionally rejected by a parent when
you needed to be comforted and now here is someone ready to comfort you, but
you are hidden behind walls, muscles tight to push away touch, wanting it but not
allowing it. And she is yearning to feel that her sexual energy is embraced
and accepted, after being shamed and shut down before, but cannot bring herself
to meet your invitation to bring her groove out. And he is waiting to feel that
someone believes in him and trusts him as capable, but scans for distrust and
hides his adult self. They are all scared to risk having what they have wanted
for so long.

And here it is. Right here, available to you. I have seen
therapy sessions when a person’s partner turns to them and with sincerity tells
them what they have been wanting to hear. And I have seen the person turn away
from it, from this gift freely given. I have to help them to slow down and see
that they can accept it. I help them relax their body so they can feel it. Even
after years of wanting and not getting, they can risk having it now. It is not
too late. They can reach out and take it. This is so vulnerable. It takes
unlearning. We have to put down the armor and the cynicism that have protected
us for so long, saying, “That is a stupid, unrealistic, pathetic thing to want.
Stop believing in it all together. Stop waiting for it, stop hoping.” But that
voice was wrong..

Here is someone offering it to you now. I invite you to stop
and think about the things you want, those deeper things that haunt you and
come out when you are feeling sensitive and unsure. And ask yourself, is it
possible that I am with someone right now who is offering that to me? Is there something
I am doing to not see it, not take it in, actively reject it? Can I admit what
I really want, no matter how simple or vulnerable it may be? Can I let myself
open to this wanting again? I invite you to take the risk.

The spiritual teacher, Pema Chodron talks a lot about one of the Noble Truths of
Buddhism, that people experience suffering and dissatisfaction with what is.
This is a given in life, you will not be perfectly pleased at all times. In
fact, there will be times when you are suffering. But she goes on, “only in the
West is this articulated as something
wrong with me”.

This insidious bit of added cruelty seems based in that
seductive myth that if we do everything right, we will always be happy and our
lives will be perfect. Perhaps no other culture has been as in thrall to this
myth as our modern American culture. We cannot get away from it. Everywhere see
ads, TV shows, crafted celebrity personas, Facebook posts, telling us that
other people achieve this constant happiness and satisfaction. Most recently with
the twist implying that only “losers” find themselves struggling. And so we
feel the normal suffering or disappointments of life, but turn them into
personal flaws.

When we struggle, we turn to self-recrimination hoping for
an answer to avoid future struggles. We craft deeply developed stories about
how we are lacking, different from other people, clearly not trying hard
enough. Because honestly it feels good to believe you can somehow avoid the
inevitable disappointments. But that belief turns on us and feels isolating and
damning when we can’t. What is wrong with
me?What did I do to deserve this
suffering?

And this pattern can go deeper into more painful shaming. In
therapy I see the hurt self blame can cause as clients get pulled into the
impossible puzzle of figuring out what they did wrong that made them deserve to
be neglected, abused, not loved in the way they needed. The truth - that there
is no good reason, that they were not the cause - is relieving for a moment.
But it is also scary because it reminds us that much of life is out of our control.
That there is unfairness and suffering. Sometimes no matter what we do.

Of course our behavior matters. Of course we can do plenty
of things to make our lives better, to make ourselves better. We don’t need to
give up wanting or trying. But we simply cannot make it all ok all the time. We
will experience heartbreak, and loss, and many, many small and less small ways
in which our life falls short of what we thought it would be. And this doesn’t
make us bad or broken. It makes us human.

And the part that makes me sad is that if only we spent our
time loving ourselves through the inevitable rather than berating ourselves
through it, the pain would pass much quicker. And we would have more time for
enjoying the beauty of life and the gorgeous fascinating individual reflections
of human imperfection all around us. Remember, you are okay, just as you are, even when times are hard.

One of the things that is important to talk about when we
talk about desire is WHAT we are desiring. One size does not fit all for sexual
pleasure and within ourselves we have diverse and sometimes even conflicting
desires that call to be fulfilled. One day we may desire to be touched gently
and another day to be pushed to our knees and made to beg. Subtle gradation’s
of desire that can seem to shift without our understanding, we feel longing or
find our minds wandering to erotic landscapes or surprise ourselves with the impulses
that arise as we are engaging with a partner. Desire, past the intensities of
puberty anyway, is rarely just for genitals to meet in a prototypical sex act.
We desire a sensation, a mood, an interactive dynamic, a way of being seen or
received, a way of seeing our self.

But this critical piece of the sexual equation often gets
left out of the discussion, at least among clinicians who are tasked with helping
people have healthy, satisfactory sexual desire. And this is especially true
when we talk about low desire – an ill defined category for a time when one’s
sex drive is lower than someone thinks is appropriate or lower than one would like.
It is true that many people over the course of their life will recognize within
themselves a flagging or even disappearance of their active sexual energy. They
may say, “I just don’t desire sex anymore”. But this is often an overstatement or
a conclusion based on minimal information.

When I work with clients who are struggling with this state,
I invite them to unpack what it is truly that they are not desiring. What is
getting in the way of sex being an enjoyable, pleasure that they could look
forward to right now? People are often surprised by the question but quickly
find they can identify crucial things that they are specifically not desiring.

One person has low desire for sex that feels pressured and
uncreative. Another for sex with someone with whom they are angry and resentful
and just had another fight this morning. Another person finds they have low
desire for sex when they feel like a failure if they don’t get an erection and
sex that is surrounded by misunderstandings and hurt. Another has low desire for
sex that hurts and another for sex when they are exhausted and another for sex
when the kids might walk in and another for sex when they feel trapped in an
emotionally draining relationship…You see where this is going.

It is rarely some generic “Sex” that we are talking about
really. It is something specific for this person. Or multiple things. But once
we know what they do not desire, then we can help them find a way to get
excited about what they do desire.

Are you a clinician
wanting to learn more about helping clients who present with low desire? Now
you can take Melissa Fritchle’s webinar, Working with Sexual Desire Issues with
Couples, online anytime, anywhere, for only $35. 1.5 CE hours through AAMFT. Find it
here

Melissa Fritchle is the author of The Conscious Sexual Self Workbook and a Holistic Psychotherapist, licensed in California as a Marriage and Family Therapist (Lic#48627). She has a private practice specializing in Sex Therapy and Couples Therapy. She travels far and wide, internationally and on the internet, to spread compassionate, sex positive, diverse, realistic sex education.